Hepatitis B virus infection in patients with metabolic syndrome: A complicated relationship. Results of a population based study

• Chronic hepatitis B is associated with lower levels of total and LDL cholesterol.
• Apolipoprotein B100 is decreased in patients with chronic hepatitis B.
• HBV DNA load is higher in HBsAg positive patients with metabolic syndrome.
• Too high or too low level of cholesterol is associated with higher HBV DNA load.

BackgroundThe presence of hepatitis B infection (HBI) and metabolic syndrome (MS) at the same time constitutes a high risk for liver cirrhosis and potentially hepatocellular carcinoma.AimIn this study we aim to explore the relationship between MS and HBI.MethodsWe used data from the cross-sectional HepaMeta study conducted in 2011 in Slovakia. Patients were tested for presence of MS, while lipid levels (total cholesterol, HDL, LDL, TG, apolipoprotein B100 and HBI (HBsAg and antiHBcIgG)) were also monitored. Viral load was measured in HBsAg positive patients.ResultsAltogether 855 patients were screened, MS was diagnosed in 25.1% of patients and 7.9% of patients presented with HBI. AntiHBcIgG antibodies were present in 34.6% patients. HBI patients had lower levels of total and LDL cholesterol along with a decreased apolipoprotein B100 (4.54 ± 0.84 vs. 5.0 ± 0.99 mmol/l, P = 0.001; 2.29 ± 0.58 vs. 2.6 ± 0.68 mmol/l, P = 0.001 and 0.71 ± 0.21 vs. 0.77 ± 0.23 mmol/l, P = 0.013 respectively). Patients diagnosed with MS had higher HBV DNA load than patients without MS — 1300.2 (95% CI 506.06–3440.41) vs. 7661.3 (95% CI 2008.17–29,228.06) IU/ml; P = 0.011. HBI patients with TC and apolipoprotein B100 in the reference range had lower HBV DNA load than patients with high or low values of TC or apolipoprotein B100.ConclusionHepatitis B patients had lower levels of total and LDL cholesterol along with a decreased apolipoprotein B100. Viral load of chronic hepatitis B patients with MS was higher than that in patients without MS.